Parents Names
Both parents contact numbers
Nationalities
Email Address
Occupations
Employers
Home Address
City
State
Zip Code
Languages spoken at home
Number of Children
Names
Ages
Gender
Dates of Birth
Child’s Interest and Activities
Are you currently expecting? YesNo
Due Date
Starting Date
Job Title
What hours do you want the Nanny to work?
Full Time ( 30 hrs or more / wk)Part Time(15-29 hrs/wk)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Total amount of guaranteed hours per week
Do you require a COVID-19 Vaccinated Nanny and/or other vaccinations?
Will weekends be required? YesNo
If yes, how often?
Will evenings be required? YesNo
Would you consider a Nanny who wanted to bring her own child to work? YesNo
If yes, what age range?
Hourly range (based on duties, experience, number and age of children and education of Nanny).
Benefits to be provided
Medical Insurance
Paid sick day
Paid Holidays
Paid Vacation
Are you prepared to pay Nanny´s Tax?
Would you be working with a Tax & Payroll Company?
Describe your home situation (size, formal, casual, condo, house, etc.).
Please check all that apply:
Run Errands, shopping?
Homework / Tutor Children
CookingChildrenFamily
LaundryChildrenFamily
Drive ChildrenOwn CarFamily Car
TravelWeekendExtended
Care for PetsYesNo
Swim with Children
Further Explanations
Would light house cleaning be required? Please explain
Do you hire other housekeeping help? YesNo
Will driving be an essential duty? YesNo
Is the car available for the Nanny´s personal use? YesNo
Describe your family to the candidates.
Do either parent work in the home? YesNo
Are there any specific needs? (physical, mental, or emotional) that your Nanny should know about.
Explain your philosophy about child discipline.
Have you had a Nanny before? If yes, what has been you experience?
Give a description of your ideal Nanny.
When would you like to schedule an appointment to chat with us? Day and time
How did you hear about our Agency? Are you currently working with another Agency?
Please give us additional information that would be helpful for us to know.
Comments.
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